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在活动性感染性心内膜炎中将二尖瓣同种异体移植物植入三尖瓣位置。

Implantation of a mitral allograft into the tricuspid valve position in active infective endocarditis.

作者信息

Skopin Ivan Ivanovich, Latyshev Mikhail Sergeevich, Britikov Dmitry Vacheslavovich, Slivneva Inessa Viktorovna

机构信息

A.N. Bakulev National Medical Research Center of Cardiovascular Surgery, Ministry of Health of the Russian Federation, Rublevskoe Shosse, 135, Moscow, 121552 Russian Federation.

出版信息

Indian J Thorac Cardiovasc Surg. 2024 Nov;40(6):711-715. doi: 10.1007/s12055-024-01712-x. Epub 2024 Mar 6.

Abstract

In cases of severe and recurrent infectious lesions affecting the right heart, one alternative option for bioprosthetic intervention is the implantation of a mitral allograft (a donor heart valve) in the position of the tricuspid valve. We present a clinical case detailing the successful implantation of a fresh mitral allograft into the tricuspid position in a 37-year-old male patient diagnosed with active infective endocarditis of the tricuspid valve and a high risk of prosthetic endocarditis. The mitral allograft was anatomically implanted with annuloplasty using an expanded polytetrafluoroethylene band. Subsequently, the patient was discharged in satisfactory condition. During the 9-month follow-up examination, no signs of infection were observed. Furthermore, the mitral allograft demonstrated excellent functionality, as evidenced by the absence of regurgitation and a mean pressure gradient measuring only 2 mmHg.

摘要

在严重且反复出现影响右心的感染性病变的情况下,生物假体干预的一种替代选择是在三尖瓣位置植入二尖瓣同种异体移植物(供体心脏瓣膜)。我们呈现一例临床病例,详细描述了在一名37岁男性患者中成功将新鲜二尖瓣同种异体移植物植入三尖瓣位置,该患者被诊断为活动性三尖瓣感染性心内膜炎且有较高的人工瓣膜心内膜炎风险。使用膨体聚四氟乙烯带进行瓣环成形术,将二尖瓣同种异体移植物进行解剖植入。随后,患者状况良好出院。在9个月的随访检查中,未观察到感染迹象。此外,二尖瓣同种异体移植物显示出优异的功能,无反流迹象,平均压力梯度仅为2 mmHg。

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